Objective To introduce the methods and the advancements of early diagnosis in primary carcinoma of gallbladder (PCG), and improve the early diagnostic rate of PCG. Methods Recent relevant literatures were reviewed. Results It was difficult in early diagnosis of PCG and with a poor prognosis. Comprehending case history and careful examination and being assisted by multiple imaging methods and molecular biology technology could markedly improve the early diagnostic rate. Conclusion Comprehending the progress will contribute a lot of improving the early diagnostic rate and selecting reasonable clinical methods to be used in early diagnosis of PCG.
【Abstract】ObjectiveTo analyze the factors influencing the prognosis of patients with bile duct carcinoma after resection. MethodsThe clinical data of 120 patients with bile duct carcinoma receiving resection in our hospital from 1980 to 2004 were collected retrospectively and clinicopathologic factors that might influence survival were analysed. A multiple factor analysis was performed through Cox proportional hazard model. ResultsThe overall 1year, 3year and 5year survival rates were 71.7%, 32.5% and 19.2% respectively. The single factor analysis showed that the major significant factors influencing survival of these patients were histological type of the lesions, lymph node metastasis, pancreatic infiltration, duodenal infiltration, resected surgical margin, perineural infiltration, peripheral vascular infiltration and depth of tumor infiltration (P＜0.05). Lymph node metastasis, pancreatic infiltration and perineural infiltration were found to be the the statistically significant factors influencing survival by multiple factor analysis through the Cox model. ConclusionThe most important prognostic factors for bile duct carcinoma after resection were lymph node metastasis, pancreatic infiltration and perineural infiltration.
【Abstract】Objective To investigate the diagnosis and treatment of primary small intestinal tumor (PSIT). MethodsEighty-eight cases of PSIT were analyzed in our hospital retrospectively. Results Thirty-six cases were diagnosed before operation, 52 cases were misdiagnosed and the percentage amounted to 59.1%. The major clinical manifestations of PSIT were abdominal pain (66 cases, 75.0%), obstruction (56 cases, 63.6%), abdominal mass (51 cases, 58.0%) and stool with blood (48 cases, 54.5%).The major pathological types of PSIT were adenocarcinoma (55.7%), sarcoma of smooth muscle (25.0%), lymphoma (13.6%), fatty sarcoma (5.7%). The tumors of 36 cases located in jejunum (40.9%), 34 cases in ileum (38.6%) and 18 cases in duodenum (20.5%).Conclusion It is difficult to diagnose PSIT before operation. The following advice could help to get a correct diagnosis: ① Surgeons should be alert when meeting a patient with the above symptoms, and then collect and analyze the clinical data comprehensively. ②Patients over 40 years with complaints of inexplicable abdominal pain, weight loss, anemia, dyspepsia and abdominal mass should be examined appropriately by gastrointestinal X-ray, gastrointestinal endoscopy, ultrasonography, CT and angiography of superior mesenteric artery. ③When the diagnosis can’t be confirmed, an exploratory operation should be performed immediately to avoid the delay of treatment. ④The treatment of PSIT includes radical resection of small intestine and chemotherapy according to the pathological results of tumor.
Tostudytheexpressionofproliferatingcellnuclearantigen(PCNA)inhumangastricneoplasmanditsclinicalsignificance.TheexpressionofPCNAwassemiquantitativelyanalysedimmunohistochemically(ABC)in10gastricadenomatouspolypand94gastriccarcinomas.Results:①PCNAlabelingindex(LI)showedasignificantdifferentiationindifferentpathologicstate(Plt;0.01),②PCNALIingastriccarcinomawasindepednetofsexandage(Pgt;0.05),butcorrelatedwiththegrowingmannerofthetumor,tumordifferentiation,serosalinfiltration,nodalmetastasisandclinicalstages(Plt;0.05),③ThecorrelationwasfoundbetweenPCNALIandprognosisofgastriccarcinoma(Plt;0.05).AmoderategradeofPCNAexpressiongenerallyhadabetterprognosis.Conclusions:TheseresultssuggestthatPCNALIisafairlygoodindextoindicatebiologicbehaviorandprognosisingastriccarcinoma.
目的 评价超低位直肠癌保肛手术的安全性和疗效。方法 回顾性分析笔者所在医院2004年10月至2010年12月期间收治的48例行管扎式结肠肛管吻合术的超低位直肠癌患者的临床资料。结果 48例患者手术均获成功，手术时间120～221min，（178±37） min； 术中出血量70～210mL，（167±38） mL； 术后排气时间2～5d，（3.1±1.2） d； 术后排便时间8～11d，（9.1±1.4） d。保留完整齿状线者27例，保留齿状线≥1/2者14例，保留齿状线＜1/2者7例。所有患者均获随访，随访时间1～7年，平均32个月。术后有3例患者发生吻合口狭窄，无吻合口漏发生。术后1年有25例患者的肛门括约肌功能达优，其中保留完整齿状线者18例，保留齿状线≥1/2者7例； 良好16例，其中保留完整齿状线者9例，保留齿状线≥1/2者7例； 一般7例，均为保留齿状线＜1/2的患者，优良率为85.4%（41/48）。随访期间，2例患者分别于术后9个月和13个月直肠癌局部复发，其中1例于术后23个月死亡。结论 超低位直肠癌保肛手术是一种安全的、可行的手术方式，可以在根治的前提下达到保肛的目的。
Objective To investigate the clinical implication on expression of HLA class I in breast cancer tissures.Methods The expression of HLA class I in 271 patients with breast cancer that underwent radical operation was examinedby using immunohistochemically， and the correlation between the expression of HLA class I and clinicalpathological characteristics and prognosis of breast cancer was analyzed. Results The b positive expression of HLA class I in breast cancer tissures was observed in 92 patients （33.9%）， the expressions of HLA class I in 179 patients （66.1%）were downregulation. The expression of HLA class I expression in breast cancer tissures was significantly associated with the axillary lymph node metastasis， TNM stage （P＜0.05）， other lymph node metastasis， and vascular invasion （P＜0.05）. The disease free survival rate of patients with positive expression of HLA class I was higher than that expression downregulation of HLA class I （P＜0.05）. Conclusion The examination of HLA class I expression is useful for the prediction of tumor progression and recurrent risk of breast cancer via the antitumor immune system.